NCLEX-RN | QB2 | Practice Exam #48 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. In applying the principles of pain treatment, what is the first consideration?
- Treatment is based on client goals.
- A multidisciplinary approach is needed.
- The client must be believed about perceptions of own pain.
- Drug side effects must be prevented and managed.
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2. A client with a severe corneal ulcer has an order for Gentamicin gtt. q 4 hours and Neomycin 1 gtt q 4 hours. Which of the following schedules should be used when administering the drops?
- Allow five minutes between the two medications.
- The medications may be used together.
- The medications should be separated by a cycloplegic drug.
- The medications should not be used in the same client.
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3. Norma asks for information about osteoarthritis. Which of the following statements about osteoarthritis is correct?
- Osteoarthritis is rarely debilitating
- Osteoarthritis is a rare form of arthritis
- Osteoarthritis is the most common form of arthritis
- Osteoarthritis affects people over 60
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4. A Patient has a dissection aortic aneurysm. The patients surgery would be categorized as:
- Elective
- Urgent
- Emergency
- Diagnostic
5. A client tells the doctor that she is about 20 weeks pregnant The most definitive sign of pregnancy is:
- Elevated human chorionic gonadatropin
- The presence of fetal heart tones
- Uterine enlargement
- Breast enlargement and tenderness
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6. Situation: As a nurse researcher you must have a very good understanding of the common terms of concept used in research. Q. The information that an investigator collects from the subjects or participants in a research study is usually called:
- Hypothesis
- Data
- Variable
- Concept
7. A client returns to the clinic for follow-up treatment following a skin biopsy of a suspicious lesion performed 1 week ago. The biopsy report indicates that the lesion is a melanoma. The nurse understands that melanoma has which characteristics? Select all that apply. 1.Lesion is painful to touch. 2.Lesion is highly metastatic. 3.Lesion is a nevus that has changes in color. 4.Skin under the lesion is reddened and warm to touch. 5.Lesion occurs in body area exposed to out-door sunlight.
- 2,3,4,5
- 1,2,3
- 3,4,5
- 2,3
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8. A child with iron deficiency complains of feeling tired all the times. The nursing diagnosis of fatigue is related to:
- A decreased ability of the blood to transparent oxygen to the tissues
- An increased paroxysmal abdominal pain and distension to the stomach
- A decreased anxiety level during hospitalization
- A decreased nutritional intake with malabsorption of nutrition
9. Which of the following is a good source of Vitamin A?
- Egg yolk
- Liver
- Fish
- Peanuts
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10. What instrument is not included in Mayo table?
- retractor
- tissue forcep
- smooth forcep
- towel forcep
11. SITUATION: a 20 year old college student was rushed to the ER of PGH after he fainted during their ROTC drill. Complained of severe right iliac pain. Upon palpation of his abdomen, Ernie jerks even on slight pressure. Blood test was ordered. Diagnosis is acute appendicitis. Q. Pre-anesthetic med of Demerol and atrophine sulfate were ordered to:
- Allay anxiety and apprehension
- Reduce pain
- Prevent vomiting
- Relax abdominal muscle
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12. Considering the residents activity, which of the following sets of vital signs should be reported to the charge nurse immediately?
- Resting: 98.6° -98-32
- After eating: 97.0°-64-24
- After walking exercise: 98.2°-98-28
- While watching television: 98.8°-72-14
13. A plan of care for a child with cerebral palsy should include all the following except:
- Physical therapy
- Play
- Feeding
- Bowel and bladder training
14. The family of an accident victim who has been declared brain-dead seems amenable to organ donation. What should the nurse do?
- Discourage them from making a decision until their grief has eased
- Listen to their concerns and answer their questions honestly
- Encourage them to sign the consent form right away
- Tell them the body will not be available for a wake or funeral
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15. A male patient complained because his scheduled surgery was cancelled because of earthquake. The hospital personnel may be excused because of:
- Governance
- Respondeat superior
- Force majeure
- Res ipsa loquitur
16. When developing a plan of care for a female client with acute stress disorder who lost her sister in a car accident Which of the following would the nurse expect to initiate?
- Facilitating progressive review of the accident and its consequences
- Postponing discussion of the accident until the client brings it up
- Telling the client to avoid details of the accident
- Helping the client to evaluate her sister's behavior
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17. Situation: Burn is cause by transfer of heat source to the body. It can be thermal, electrical radiation or chemical. Q. Which of the following BEST describes superficial partial thickness burn or first degrees burn?
- Structures beneath the skin and damage
- Dermis is partially damaged
- Epidermis and dermis are both damaged
- Epidermis is damaged
18. A client with schizophrenia is started on Zyprexa (olanzapine). Three weeks later the client develops severe muscle rigidity and elevated temperature. The nurse should give priority to:
- Withholding all morning medications
- Ordering a CBC and CPK
- Administering prescribed anti-Parkinsonian medication
- Transferring the client to a medical unit
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19. A nursing instructor delivers a lecture to nursing students regarding the issue of clients rights and asks a nursing student to identify a situation that represents an example of invasion of client privacy. Which situation, if identified by the student, indicates an understanding of a violation of this client right?
- Performing a procedure without consent
- Threatening to give a client a medication
- Telling the client that he or she cannot leave the hospital
- Observing care provided to the client without the client's permission
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20. A child is hospitalized because of persistent vomiting. The nurse should monitor the child closely for which problem?
- Diarrhea
- Metabolic acidosis
- Metabolic alkalosis
- Hyperactive bowel sounds
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21. A community health nurse is providing a health teaching to a woman infected with herpes simplex 2. Which of the following health teaching must the nurse include to reduce the chances of transmission of herpes simplex 2?
- "Abstain from intercourse until lesions heal"
- "Therapy is curative."
- "Penicillin is the drug of choice for treatment."
- "The organism is associated with later development of hydatidiform mole."
22. In which step of the nursing process would the nurse ask a patient if the medication she administered relieved his pain?
- Assessment
- Analysis
- Planning
- Evaluation
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23. A client presents in the emergency department after falling from a roof. A fracture of the femoral neck is suspected. Which of these assessments best support this diagnosis.
- The client reports pain in the affected leg
- A large hematoma is visible in the affected extremity
- The affected extremity is shortened, adducted, and extremely rotated
- The affected extremity is edematous.
24. The client is receiving peritoneal dialysis. If the dialysate returns cloudy the nurse should:
- Document the finding.
- Send a specimen to the lab.
- Strain the urine.
- Obtain a complete blood count.
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25. Provides a concise method of organizing and recording data about the client It is a series of flip cards kept in portable file used in change of shift reports.
- Progress Note
- SOAPIE
- Kardex
- Change of shift report
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26. The client who is admitted with thrombophlebitis has an order for heparin. The medication should be administered using a/an:
- Buretrol
- Infusion controller
- Intravenous filter
- Three-way stop-cock
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27. A community health nurse visits a patient who has suffered a stroke. The patients spouse explains to the nurse that the patient chokes while eating some times. Which of the following referral orders would the nurse anticipate needing for this patient?
- Speech therapist
- Dietician
- Physical therapist
- Neurologist
28. Situation: You are assigned to take care of a group of patients across the lifespan. A client says she heard from a friend that you stop having periods once you are on the "pill" The most appropriate response would be:
- "The pill prevents the uterus from making such endometrial lining, that is why period may often be scant or skipped occasionally"
- "If your friend has missed her period, she should stop taking the pills and get a pregnancy test"
- "The pill should cause a normal menstrual period every month. It sounds like your friend has not been taking the pills properly"
- "Missed period can be very dangerous and may lead to the formation of precancerous cells"
29. The nurse is changing the ties of the client with a tracheotomy. The safest method of changing the tracheotomy ties is to:
- Apply the new tie before removing the old one.
- Have a helper present.
- Hold the tracheotomy with the nondominant hand while removing the old tie.
- Ask the doctor to suture the tracheostomy in place.
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30. Levothyroxine is prescribed for a client diagnosed with hypothyroidism. Upon review of the client's record, the nurse notes that the client is taking warfarin. Which modification to the plan of care should the nurse review with the client's health care provider?
- A decreased dosage of levothyroxine
- An increased dosage of levothyroxine
- A decreased dosage of warfarin sodium
- An increased dosage of warfarin sodium
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31. Myeioablation using chemotherapeutic agents is useful in cancer treatment because:
- It destroys the myelocytes (muscle cells).
- It reduces the size of the cancer tumor
- After surgery, it reduces the amount of chemotherapy needed.
- It destroys the bone marrow prior to transplant.
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32. SITUATION: Knowledge of the drug prophantheline bromide [Probanthine] Is necessary in treatment of various disorders. Q. What should the nurse tell clients when taking Probanthine?
- Avoid hot weathers to prevent heat strokes
- Never swim on a chlorinated poo:
- Make sure you limit your fluid intake to 1L a day
- Avoid cold weathers to prevent hypothermia
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33. Situation: As a beginner in research, you are aware that sampling is an essential element of the research process. Q. Random sampling ensures that each subject has:
- Been selected systematically
- An equal chance of selection
- Been selected based on set criteria
- Characteristics that match other samples
34. The nurse is providing dietary teaching for a client with elevated cholesterol levels. Which cooking oil is not suggested for the client on a low-cholesterol diet?
- Safflower oil
- Sunflower oil
- Coconut oil
- Canola oil
35. A nursing instructor asks a nursing student to describe human immunoglobulin. The student correctly states that these types of vaccine are:
- Vaccine that have their virulence diminished so as to not produce a full blown clinical illness
- Vaccine that contains pathogens made inactive by either chemicals or heat
- Bacterial toxins that have been made inactive by either chemicals or heat
- Vaccines collected from pooled blood of people and provide antibodies to variety of diseases
36. Situation: During the morning endorsement, the outgoing nurse informed the nursing staff that Regina, 5 years old, was given Flurazepam (Dalmane) 15 mg at 10:00pm because she had trouble going to sleep. Before approaching Regina, the nurse read the observation of the night nurse. Q. Which of these responses indicate that Regina needs further discussion regarding special instructions?
- "I have to take this medicine judiciously"
- "I know 1 will stop taking the medicine when there is an advice form the doctor for me to discontinue."
- "I will inform you and the doctor any untoward reactions I have."
- "I like taking this sleeping pill. It solves my problem of insomnia. I wish I can take it for life"
37. Situation: Mrs. Damian an immediate post op cholecystectomy and choledocholithotomy patient, complained of severe pain at the wound site. Q. In a pain assessment, which of the following condition is a more reliable indicator?
- Pain rating scale of 1 - 10
- Facial expression and gestures
- Physiological responses
- Patients description of the pain sensation
38. A client with paranoid schizophrenia has persecutory delusions and auditory hallucinations and is extremely agitated. He has been given a PRN dose of Thorazine IM. Which of the following would indicate to the nurse that the medication is having the desired effect?
- Complains of dry mouth
- State he feels restless in his body
- Stops pacing and sits with the nurse
- Exhibits increase activity and speech
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39. An adolescent client with cystic acne has a prescription for Accutane (isotretinoin). Which lab work is needed before beginning the medication?
- Complete blood count
- Clean-catch urinalysis
- Liver profile
- Thyroid function test
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40. In which of the following diseases would bone marrow transplantation not be indicated in a newly diagnosed client?
- Acute ymphocytic leukemia
- Chronic myeloid leukemia
- Severe aplastic anemia
- Severe combined immunodeficiency
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41. Mr. Liberatore, age 76, is admitted to your unit He has a past medical history of hypertension, DM, hyperlipidemia. Recently he has had several episodes where he stops talking mid sentence and stares into space. Today the episode lasted for 15 minutes. The admission diagnosis is impending CVA. Q. A thorough history reveals that hormonal changes associated with menstruation may have triggered Julie's migraine attack. In investigating Julie's history what factors would be least significant in migraine?
- seasonal allergies
- trigger foods such as alcohol, MSG, chocolate
- family history of migraine
- warning sign of onset, or aura
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42. The nurse is providing postpartum instructions to a client who will be breast-feeding her newborn. The nurse determines that the client has understood the instructions if she makes which statements? Select all that apply. 1."I should wear a bra that provides support." 2."Drinking alcohol can affect my milk supply." 3."The use of caffeine can decrease my milk supply." 4."I will start my estrogen birth control pills again as soon as 1 get home." 5."I know if my breasts get engorged, I will limit my breast-feeding and supplement the baby." 6."I plan on having bottled water available in the refrigerator so 1 can get additional fluids easily."
- 1,2,3,6
- 1,2,3,4,5,6
- 3,5,6
- 1,4,6
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43. The partograph is a tool used to monitor labor. The maternal parameters measured/ monitored are the following EXCEPT:
- Vital signs
- Fluid intake and output
- Uterine contraction
- Cervical dilatation
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44. Situation: During the morning endorsement, the outgoing nurse informed the nursing staff that Regina, 5 years old, was given Flurazepam (Dalmane) 15 mg at 10:00pm because she had trouble going to sleep. Before approaching Regina, the nurse read the observation of the night nurse. Q. The nurse engages Regina in the process of mutual inquiry to provide an opportunity for Regina to
- face emerging problems realistically
- conceptualize her problem
- cope with her present problem
- perceive her participation in an experience
45. Which of the following is the reason to perform a spinal tap on a client newly diagnosed with leukemia?
- To rule out meningitis
- To decrease intracranial pressure
- To aid in classification of the leukemia
- To assess for central nervous system infiltration
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46. A male Patient is undergoing chemotherapy may also be given the drug allopurinol (Zyloprim, Aloprim). Allopurinol inhibits the synthesis of uric aciD. Concomitant administration of allopurinol prevents:
- Myelosuppression.
- Gout and hyperuricemia.
- Pancytopenia.
- Cancer cell growth and replication
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47. A Patient is recovering following surgery for placement of a colostomy. The nurse goes to the patient's room to instruct the patient how to care for the colostomy. The patient's roommate has visitors and the patient does not want to participate at this time. What should the nurse do?
- Document the patient's refusal and add non-compliance to the care plan
- Tell the patient that this is vital information and may delay discharged
- Plan a time convenient to both the patient and the nurse
- Pull the curtain around be bed and speak, ensuring privacy
48. A patient who is receiving chemotherapy has a platelet count of 49,000/mm3 (normal value 150,000 to 400,000/ mm3 ). Which of the following nursing action is necessary?
- Minimize invasive procedure
- Crush oral medications
- Limit intake of vitamin K rich foods
- Monitor the temperature every 4 hours
49. A child has ingested an entire bottle acetaminophen(Tylenol). Which of the following organs is affected?
- Liver
- Brain
- Kidneys
- Gallbladder
50. Before the administration of digoxin, the nurse completes an assessment to a toddler client for signs and symptoms of digoxin toxicity. Which of the following is the earliest and most significant sign of digoxin toxicity?
- Tinnitus
- Nausea and vomiting
- Vision problem
- Slowing in the heart rate
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